Comparative Analysis of the Efficiency of Blind and Controlled Techniques of Brachial Plexus Blockade
The aim: improve the quality of anesthesia in surgery on the upper extremity using blind and nervestimulater controlled blockade of the brachial plexus.
Materials and methods. There was performed a supraclavicular brachial plexus blockade in 41 patients while operative interventions on the upper extremity. In the first group of 21 patients plexus identified by paresthesia at angle of the injection needle of 45–90°. In the second group of 20 people identifying of the brachial plexus was performed using neurostimulator at an acute angle of the injection needle (30°) in a state of medication sleep through a combination of sibazon with thiopental or propofol. In both groups a combination of 1.5% lidocaine and 0.5% bupivacaine was used for a blockade.
Results and discussion. It was established that the use of blind brachial plexus blockade at right angles does not always provide adequate analgesic protection, is associated with increased systolic arterial pressure during surgery. A neurostimulator blockade at an acute angle of the injection needle (30°) provides 100% success blockade, stable hemodynamics, prolonged motor and sensory block, depth of anesthesia and requires fewer medications for analgesia and sedation. Anesthesia controlled by a neurostimulator in a state of medication sleep provides more comfortable state of a patient during surgery and better patient’s relation to anesthesia compared to the blind technique.
Conclusions. Summarizing the comparative analysis of both brachial plexus block techniques it was concluded that a neurostimulater identification of the brachial plexus and puncture at an acute angle (30°) provide better fullness and length of the block. This technique correlates with 100% successful anesthesia, higher analgetic effect, which requires fewer additional use of anesthetic drugs and narcotic analgesics, stable hemodynamic parameters, longer duration of anesthesia and patient’s better comfort during surgery.
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